We recently changed medical insurance plans and switched to a new pediatrician. My wife is in nursing school and one of the things that's drilled into students is the importance of handwashing to avoid the spread of pathogens. Not surprisingly, she noticed that even though the examination room has a sink and hand-sanitizer dispensers, our new pediatrician doesn't use them.

I pointed out to my wife that the doctor might wash his hands before coming into the room for some reason. He also comes highly recommended from friends and we like just about everything else about his office. But we really can't afford to risk our children getting exposed to more diseases than they already are.

Is there some non-insulting way to ask a pediatrician to wash his hands just before examining our children?

4 Answers
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First off, the doctor must wash his/her hands after entering the room, period. The doctor opened the door with his hand, right? That's a (major) point of contagion right there. Unless you're in some futuristic practice with automatic doors, I would never excuse the doctor from not washing post-entering the room.

Second, unfortunately, doctor handwashing is a major problem. Major studies have repeatedly found very low wash rates (This Study found a 40%-50% rate, for example), and the problem is very difficult to address from a management perspective.

From a parent's perspective, the odds are you can't really effect change here. That's not to say you shouldn't try; but I wouldn't presume it's likely to work. Doctors are creatures of habit, and if they're not in the habit of hand washing, they probably won't easily become in that habit - especially if only a few patients mention it.

What can you do? First, you should certainly mention it to the doctor the next time he comes in. "Hi, would you mind washing your hands before you examine my child?" Polite but matter of fact seems reasonable here. It's a reasonable request, given it's your child's health, and as long as you're not critical or condescending about it, the doctor shouldn't take it wrong. If that goes reasonably well (ie, the doctor doesn't object and does wash his hands), then continue that - each time. It may simply be that the doctor isn't in the habit and appreciates the reminder. If the doctor does take it badly, you may need to choose between a doctor with good hygiene and that doctor.

You also could wash your hands after the doctor comes in. That might serve as a subtle reminder, after all. If your child/children are old enough, you might encourage them to take an interest in this; doctors (particularly pediatricians) often are familiar with children who are a bit pushy about things around them (ie, most children) and could take it better from the child. This particularly works if you have a child like mine who enjoys washing and hates being dirty.

Finally, I would not address this with the practice administration or anyone other than the doctor. While it's possible some volume of complaints might initiate a change this way, it's more likely to irritate the doctor, and doesn't seem likely to be successful if the more direct method wasn't.

If you're in England please do report all instances you see of people touching a patient without washing their hands first. You're not making "an official complaint" and you're not saying that the clinician didn't wash their hands. You're just making a comment to say that you did not see the clinician washing their hands.
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DanBealeMar 30 '14 at 19:04

I say, in a clear firm tone "please can you wash your hands before continuing?"

If I wanted to be delicate I would say "Sorry, but I didn't see you wash your hands. Would you mind doing so before you continue? Thanks."

In England it is always acceptable to remind clinicians about hand hygiene and patients are encouraged to do so. I would raise a complaint about anyone reacting negatively to my request for hand hygiene.

I have had to mention this to a few clinicians but they have always been fine with it.

Doctors certainly feel dejected if they are being drawn attention for their hygiene. Being a healthcare provider, I know this. That's because advising something about their profession (how to examine a baby does include washing hands with sanitizer and that's what is taught to all child specialists) is nothing less than advising fish how to swim. It's overreacting but it's the truth.

Now, how you do that?

There is one good way which won't put anyone (a doc and you) in humiliation. There should be a feedback/suggestion box. Write it down (anonymously) and just drop your suggestion. If the management is active enough (I hope it is!), it'll be conveyed in a very straightforward way. You asking something to do and the management advising to do it makes a lot of difference. Alternatively, you can also put an anonymous mail to the organization with polite words (no offense at all) starting with In the interest of patients and organizations, we'd like to draw your attention to a trivial matter which could turn out to be a major health risk..." and so on...

@downvoter, may I know what's so bad about this suggestion?
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Maulik VMar 31 '14 at 15:04

While I am not the down-voter, I debated that on this answer. If you are in the business of human care and you don't demonstrate care for yourself, but expect others to trust you, then how you make your customers feel is more important than how you feel. Set an example and accept it when you fail and someone points it out... are any of us beyond improvement? making mistakes? falling into bad routines? Finally, being anonymous just speaks of cowardice to me. I tell my Dr's everything -- sometimes I learn as a result, and rarely they learn from me.
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Jeremy MillerMar 31 '14 at 15:30

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@JeremyMiller I think here we are discussing about a person forgetting something than the code of ethics. While you think it's cowardice, I call it drawing attention in a smart way. After all, the feedback/suggestion box DOES have plenty of suggestions without the names of the persons wrote it. It's okay, nothing upsetting to the management or doctor.
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Maulik VMar 31 '14 at 16:03

I missed the OP's claim that this was forgetting. I still don't see such a claim and am not willing to just make that leap. My Dr's wash their hands. Period. I could care less about upsetting them if they don't care about upsetting me.
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Jeremy MillerMar 31 '14 at 18:40

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@JeremyMiller that depends. You are straightforward and seem to bother less whatever a doctor will think. But here, OP cares and that's why he has put a question! Had he been you, this wouldn't have been the problem but unfortunately, that's not the case! Not all have candidness some care what others will think of their remark.
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Maulik VApr 1 '14 at 4:55